Trump just made a huge move that could blow up Obamacare

The White House announced
Thursday night that President Donald Trump would end
cost-sharing-reduction payments, a move that could wreck the
Affordable Care Act's individual insurance exchanges and send
healthcare costs soaring for many Americans.

"Based on guidance from the Department of Justice, the Department
of Health and Human Services has concluded that there is no
appropriation for cost-sharing reduction payments to insurance
companies under Obamacare," the White House said in a statement.
"In light of this analysis, the Government cannot lawfully make
the cost-sharing reduction payments."

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The payments were introduced by the ACA to help offset the cost
to insurers of offering affordable plans to poor Americans.
Insurers
have repeatedly warned that if the payments were cut off,
they would be forced to raise premiums to make up the financial
loss.

The CSR payments have long been disputed. The
Republican-controlled House of Representatives sued the Obama
administration in 2014, arguing the payments were illegal since
they were being appropriated by the executive branch instead of
Congress, which never authorized them.

A federal court ruled in favor of the House, but the Obama
administration appealed the ruling, allowing the payments to
continue. The Trump administration has kicked the can down the
road on the appeal and appropriated the payments on a monthly
basis,
attempting to use them as leverage in multiple negotiations
with Democrats.

In August, a federal judge ruled that 17 states and the District
of Columbia
could continue the lawsuit even if the Trump administration
pulled out of the appeal since the end of the payments would
directly affect residents. This could allow the payments to
continue despite the announced decision to end them.

Democrats have repeatedly sought to appropriate the payments
through congressional action, most recently in bipartisan talks
between Republican Sen. Lamar Alexander, the chairman of the
Senate Committee on Health, Education, Labor, and Pensions, and
the ranking member of that committee, Democratic Sen. Patty
Murray.

House Minority Leader Nancy Pelosi and Senate Minority Leader
Chuck Schumer decried Trump's actions in a statement released
minutes after the decision was announced.

"Sadly, instead of working to lower health costs for Americans,
it seems President Trump will single-handedly hike Americans'
health premiums," they said. "It is a spiteful act of vast,
pointless sabotage leveled at working families and the middle
class in every corner of America. Make no mistake about it, Trump
will try to blame the Affordable Care Act, but this will fall on
his back and he will pay the price for it."

Many Republicans have resisted the idea of Congress appropriating
the payments, but some moderate GOP members think it is necessary
to maintain stability in the insurance exchanges.

"Cutting health care subsidies will mean more uninsured in my
district," Republican Rep. Ileana Ros-Lehtinen tweeted, adding
that the president "promised more access, affordable coverage,"
but that this would do the opposite.

House Speaker Paul Ryan applauded the decision on procedural
grounds, saying the method of appropriating the payments through
the executive branch was illegal.

"Today's decision by the Trump administration to end the appeal
of that ruling preserves a monumental affirmation of Congress's
authority and the separation of powers," Paul said in a
statement. "Obamacare has proven itself to be a fatally flawed
law, and the House will continue to work with Trump
administration to provide the American people a better system."

How much ending the payments could destabilize the exchanges is a
subject of debate. Some health-policy experts have said that
without the payments, the individual insurance exchanges
could be devastated as insurers leave and premiums skyrocket.
The nonpartisan Congressional Budget Office, however, has found
that while the move
would cause some pain in the short term for the exchanges,
they would eventually find their footing.

Earlier Thursday, Trump
signed an executive order to allow two types of healthcare
plans that would let people skirt some Obamacare regulations - a
move he said was designed to undermine the healthcare law.
Experts have said that the introduction of these plans could
increase costs for sicker Americans.